HIV testing available, but care scarce

HIV testing may be easier and cheaper than ever before. But as the economy continues to slump, care may become more difficult to come by.

As of Dec. 1, Yale-New Haven Hospital has adopted a policy of offering free HIV testing to at-risk individuals in its emergency room — becoming the third hospital in the state to do so. Since the policy came into effect, one person has already been identified as HIV positive who otherwise would not have known he/she was infected. Still, some HIV/AIDS activists remain skeptical about the overall effectiveness of this program in combating the epidemic.

“Everyone should know their status,” Gregg Gonsalves, an HIV/AIDS activist and student in the Eli Whitney program, said. “But the question is, does knowing your status get you into care?”

The program is part of a Center for Disease Control and Prevention initiative that aims to make HIV testing in hospital emergency rooms routine and to decrease the unwitting transmission of the disease. The tests are typically taken via a mouth swab, and results are available within approximately twenty minutes. Patients must give their consent for the test to be taken, and the results are confidential.

Although the Y-NH hospital program began last month, for the past year, community health centers and sexually transmitted disease testing clinics have offered free HIV testing even to patients who are not symptomatic, according to the CDC. The two other hospitals in Conn. that offer free HIV testing are Waterbury Hospital and Lawrence & Memorial Hospital in New London.

Gonsalves explained that the most at-risk groups for HIV infection are those who generally have the least access to care. Men who have sex with men, or women of Hispanic or African-American ethnicity, are particularly vulnerable.

While the program is no doubt a step in the right direction, Yale School of Public Health professor A. David Paltiel thinks there remains room for improvement.

“I just wish they were doing an evaluation alongside it and that they were implementing what the CDC recommended, which is that you test every sexually active individual, regardless of risk — because we, as people, are very bad at assessing risk,” Paltiel said.

Additionally, the effectiveness of the new program may suffer because of the economic downturn. The Conn. Department of Public Health recently proposed a funding cut of 40 percent for HIV/AIDS services, Shawn Lang, the Conn. AIDS Resource Coalition’s Director of Public Policy, said.

Lang said if the proposed cut goes through, there will be fewer resources available to aid those who test positive.

“The state’s HIV care system is already bursting at the seams,” she said. “The fact that the HIV testing program is going to bring people into care for whom services will likely be cut drastically is ridiculous.”

Added Gonsalves: “Testing can be a door to services, but in and of itself, it is insufficient. I don’t know how much good it does.”

Nationally, Connecticut has the fifth highest number of HIV positive individuals per capita of the 50 states — approximately a quarter of whom do not know their status — and is one of 26 states participating in the program, according to the CDC.